Henti Nafas Pada Anak Dan Dewasa

8/16/2019 Henti Nafas Pada Anak Dan Dewasa

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Airway and RespiratoryAirway and Respiratory

EmergenciesEmergenciesDr. Anna Millizia, M.Ked (An), Sp. An



Life ThreatsLife Threats

Two most important lifesaving skills:

◦ Airwa !are

◦ "es!#e $reat%ing

T%e A&'s !onsist of:

◦ Airwa

◦ &reat%ing

◦ 'ir!#lation



Respiratory SystemRespiratory System

To maintain life, all %#mans m#st %avefood, water, and ogen.

◦ a!k of ogen, even for a few min#tes, !anres#lt in irreversi$le damage and deat%.

T%e main p#rpose of t%e respirator

sstem is to work wit% t%e !ir!#latorsstem to provide ogen and remove!ar$on dioide via t%e red $lood !ells.



Time is Critical!Time is Critical!

*vent#all all !ells will die if deprived ofogen. &rain and %eart are t%e most

sensitive.



Anatomy of theAnatomy of theRespiratory SystemRespiratory System

◦ At t%e $a!k of t%e t%roat are two passages: T%e esop%ag#s

T%e tra!%ea◦ T%e epiglottis %elps prevent food or waterfrom entering t%e airwa.

◦ T%e airwa divides into t%e $ron!%i.

◦ T%e l#ngs are lo!ated on eit%er side of t%e%eart. T%e rig%t l#ng %as + lo$es, t%e left %as and t%e %eart sits slig%tl more towards t%eleft side.




-t%er parts of t%e respirator sstem:(!ontd)

◦ T%e smaller airwas t%at $ran!% from t%e$ron!%i are !alled $ron!%ioles.

◦ At t%e end of t%e $ron!%ioles are tin air sa!s!alled alveoli.

◦ T%e e!%ange of ogen and !ar$on dioideo!!#rs in t%e alveoli.










T%e l#ngs !onsist of soft, spong tiss#e wit% nom#s!les.

◦ Movement of air into t%e l#ngs depends on movementof t%e ri$ !age and t%e diap%ragm m#s!les.

◦ /%en t%e diap%ragm !ontra!ts d#ring in%alation, itflattens and moves downward, in!reasing t%e size oft%e !%est !avit.

◦ Air moves in and o#t of t%e l#ngs $e!a#se of press#re!%anges, moving from %ig% to low press#re to e0#alize.

◦ -n e%alation, t%e diap%ragm relaes and on!e again$e!omes dome s%aped, de!reasing t%e size of t%e !%est!avit.


http://slidepdf.com/reader/full/henti-nafas-pada-anak-dan-dewasa 10/38Check for ResponsivenessCheck for Responsiveness

Ask !allers to:

◦ *val#ate t%e vi!timsresponsiveness. 1f

t%eres a response,ass#me t%at t%epatient is !ons!io#sand %as an openairwa.

◦ 1f t%ere is noresponse, advise!allers to gentls%ake t%e patientss%o#lder and repeat0#estions.



““A” s for AirwayA” s for Airway

1n %ealt% individ#als, t%e airwaa#tomati!all stas open.

An in2#red or serio#sl ill person is nota$le to prote!t t%e airwa and it ma$e!ome $lo!ked.

◦ 3o# m#st take steps to %ave !allers !%e!k t%eairwa and !orre!t an pro$lems.



Correct the locked AirwayCorrect the locked Airway

1n an #n!ons!io#s patient ling on %is or%er $a!k, t%e passage of air t%ro#g% $ot%

nose and mo#t% ma $e $lo!ked $ t%etong#e.

◦ T%e tong#e is atta!%ed to t%e lower 2aw.

◦ A partiall $lo!ked airwa often prod#!es asnoring so#nd.

◦ T%e %ead tilt !%in lift will fi t%e pro$lem.




4ead tilt5!%in liftmane#ver

◦ 6la!e t%e patient on %is

or %er $a!k.

◦ 6la!e one %and on t%epatients fore%ead andappl firm press#re$a!kward.

◦ 6la!e t%e tips of o#rfingers #nder t%e $onpart of t%e lower 2aw.

◦ ift t%e !%in forward andtilt t%e %ead $a!k.




6otential $lo!ks in!l#de:

◦ Se!retions s#!% as vomit, m#!#s, or $lood

◦ 7oreign o$2e!ts s#!% as !and, food, or dirt

◦ Dent#res or false teet%

1f t%ere is ant%ing in t%e patients

mo#t%, remove it.

7inger sweeps !an $e done 0#i!kl and re0#ireno spe!ial e0#ipment.



Recovery "ositionRecovery "osition

1f an #n!ons!io#s patient is $reat%ing and %asnot s#ffered tra#ma, pla!e t%e patient in t%e

re!over position.◦ 4elps keep t%e patients airwa open

◦ Allows se!retions to drain o#t of t%e mo#t%

◦ 8ses gravit to %elp keep t%e patients tong#eand lower 2aw from $lo!king t%e airwa



““” is for reathing” is for reathing

8se t%e look, listen, and feel te!%ni0#e.

◦ ook for t%e rise and fall of t%e patients !%est.

◦ isten for t%e so#nds of air passing into ando#t of t%e patients nose or mo#t%.

◦ 7eel t%e air moving on t%e side of o#r fa!e.

Ad#lts %ave a normal $reat%ing rate of 9to $reat%s per min#te, !%ildren 9; to+ and infants ; to ;.



#o reathing$%% Start C"R#o reathing$%% Start C"R

'a#ses of respirator arrest◦ 4eart atta!ks

◦ Me!%ani!al $lo!kage or o$str#!tion !a#sed $ t%etong#e

◦ <omit#s, parti!#larl in a patient weakened $ a!ondition s#!% as a stroke

◦ 7oreign o$2e!ts

◦ 1llness or disease

◦ Dr#g overdose

◦ 6oisoning

◦ Severe loss of $lood

◦ *le!tro!#tion $ ele!tri!al !#rrent or lig%tning



C & A ' C & A '

+ !ompressions in t%e !enter of t%e !%est, in!%es deep. 6#s%ing %ard and fast, 9

times per min#te.

As o# perform $reat%ing, keep t%e patientsairwa open. (%ead=tilt)

◦ 6in!% t%e nose, take a deep $reat%, and $lowslowl into t%e mo#t% for 9 se!ond.

◦ "emove o#r mo#t% and let t%e l#ngs deflate.

◦ &reat%e for t%e patient a se!ond time.

◦ Alternate +: !ompressions and $reat%s, #ntil t%e

patient responds or eperien!ed %elp takes over.



Ca(ses of Airway )*str(ctionCa(ses of Airway )*str(ction

T%e most !ommon airwa o$str#!tion ist%e tong#e.

◦ 1f t%e tong#e is $lo!king t%e airwa, t%e %eadtilt5!%in lift mane#ver will !lear t%e pat!% forair movement.

7ood is t%e most !ommon foreign o$2e!tt%at !a#ses an airwa o$str#!tion.

◦ 1f a foreign $od is lodged in t%e air passage,o# m#st #se ot%er te!%ni0#es to remove it.



Are +o( Choking,Are +o( Choking,

• 1f !ons!io#s:Ask t%e patient, >Are o#!%oking?@

◦ 1f t%e patient !an repl, t%e airwa is not!ompletel $lo!ked.

◦ 1f t%e patient !annot speak or !o#g%, t%e airwa is!ompletel $lo!ked.

Mild airwa o$str#!tion◦ T%e patient !o#g%s and gags.

◦ T%e patient ma $e a$le to speak, $#t wit%diffi!#lt. *n!o#rage t%e patient to !o#g%.




Severe airwa o$str#!tion

◦ T%e patient is #na$le to $reat%e in or o#t and

spee!% is impossi$le.

◦ -t%er smptoms ma in!l#de: 6oor air e!%ange 1n!reased $reat%ing diffi!#lt A silent !o#g% oss of !ons!io#sness in + to min#tes

◦ Treatment involves a$dominal t%r#sts.




Airwa o$str#!tion in an ad#lt or !%ild

◦ 1f t%e patient is !ons!io#s, stand $e%ind %im

or %er and perform a$dominal t%r#sts.

◦ 6erform '6" on a patient w%o %as $e!ome#nresponsive.




Airwa o$str#!tion in an infant

◦ 1f t%e infant %as an a#di$le !r, t%e airwa is

not !ompletel o$str#!ted.

◦ 8se a !om$ination of ; $a!k slaps and ; !%estt%r#sts, if t%e infant is awake $#t not$reat%ing from airwa o$str#!tion.

◦ 1f t%e infant $e!omes #nresponsive: &egin '6". 'ontin#e '6" #ntil *MS personnel arrive.



reathing for "atients -ithreathing for "atients -ithStomasStomas

'%e!k ever patient for t%e presen!e of a stoma.

1f o# lo!ate a stoma, keep t%e patients ne!k

straig%t.*amine t%e stoma and !lean awa an m#!#s

in it.

6la!e o#r mo#t% dire!tl over t%e stoma and#se t%e same pro!ed#res as in mo#t%=to=mo#t%

$reat%ing.1f t%e patients !%est does not rise, seal t%e

mo#t% and nose wit% one %and and t%en $reat%et%ro#g% t%e stoma.



.astric /istention.astric /istention

-!!#rs w%en air is for!ed into t%estoma!% instead of t%e l#ngs

1n!reases t%e !%an!e t%at t%e patient willvomit

&reat%e slowl into t%e patients mo#t%,

2#st eno#g% to make t%e !%est rise.Make s#re airwa is properl tilted open.



Respiratory EmergenciesRespiratory Emergencies

T%ere are a variet of pro$lems t%at!an !a#se Diffi!#lt in &reat%ing(D1&) or S%ortness of &reat% (S-&).

T%e rest of t%e presentation will!over some of t%ose !onditions.



Signs of nade0(ate reathingSigns of nade0(ate reathing

Bois respirations, w%eezing, or g#rgling (rales or!ra!kles)

◦ %ttp:CCwww.easa#s!#ltation.!omCl#ng=so#nds=referen!e=g#ide.a

sp !li!k on t%is link to listen to a$normal l#ng so#nds

"apid or gasping respirations

6ale or $l#e skin

1n!reased work of $reat%ing

Talking in 9 or word senten!es T%e most !riti!al sign is respirator arrest, w%i!% is

!%ara!terized $:◦ a!k of !%est movements

◦ a!k of $reat% so#nds

◦ a!k of air against t%e side of o#r fa!e

http://www.easyauscultation.com/lung-sounds-reference-guide.aspx






//

'a#ses:◦ 8pper or lower airwa infe!tion

◦ A!#te p#lmonar edema (7l#id in l#ngs)◦ '%roni! o$str#!tive p#lmonar disease ('-6D)

◦ Ast%ma

◦ 4a fever

◦ 4perventilation sndrome◦ *nvironmentalCind#strial epos#re

◦ 'ar$on monoide poisoning

◦ 1nfe!tio#s diseases



//

'a#ses (!ontd)

◦ Anap%lais (Severe Allergi! "ea!tion)

◦ Spontaneo#s pne#mot%ora ('ollapsed #ng)

◦ 6le#ral eff#sion (7l#id aro#nd t%e #ng)

◦ 6rolonged seiz#res

◦ -$str#!tion of t%e airwa ('%oking)

◦ 6#lmonar em$olism (!lot in #ng area)



Airway nfectionsAirway nfections

&ron!%itis 5 inflammation of $ron!%ioles. 6atientswill %ave a prod#!tive !o#g% and w%eezing.

'ommon 'old 5 viral infe!tion wit% swollenm#!o#s mem$ranes and e!ess fl#id prod#!tionfrom sin#ses and nose.

T& 5 a respirator disease t%at !an la dormantin t%e l#ngs for ears. 1s spread $ respiratordroplets.

6ne#monia 5 viral or $a!terial infe!tion t%at !andamage l#ng tiss#e. '%ara!terized $ prod#!tive!o#g%, fever and !ongestion.

Dip%t%eria 5 A %ig%l !ontagio#s disease t%at!a#ses a laer of de$ris to form in t%e #pper

airwa and !an !a#ses o$str#!tion. T%is is a rarepro$lem.



Airway nfectionsAirway nfections

*piglottitis 5 &a!terial infe!tion t%at affe!ts mostl s!%ool aged!%ildren. 'a#ses swelling of t%e flap a$ove t%e larn. 6atientswill %ave Stridor (a %ars%, %ig% pit!%ed so#nd) as t%e air movespast t%e swelling. T%e will also %ave a fever, sore t%roat and

drooling. 'ro#p 5 <iral 1nfe!tion, #s#all seen in !%ildren #nder +ears old.

'a#ses inflammation of t%e airwa and a >seal $ark@ tpe of!o#g%.

"S< 5 4ig%l !ontagio#s infe!tion t%at is spread t%ro#g% air$ornedroplets. Affe!t o#ng !%ildren and !an lead to more serio#s l#ndor %eart pro$lems.

6ert#ssis (/%ooping 'o#g%) 5 4ig%l !ontagio#s $a!terialinfe!tion t%at mostl effe!ts !%ildren #nder . 6atient will %ave afever and !o#g%ing episodes w%ere t%e !ant !at!% t%eir $reat%.

SA"S 5 6otentiall life=t%reatening viral infe!tion t%at starts wit%fl#=like smptoms and !an progress to deat%. Spread fromperson=to=person !onta!t.



Chronic )*str(ctive "(lmonaryChronic )*str(ctive "(lmonary/isease 1C)"/2/isease 1C)"/2

Slow pro!ess of dilation and disr#ption of airwasand alveoli

'a#sed $ !%roni! $ron!%ial o$str#!tion7o#rt% leading !a#se of deat%

To$a!!o smoke !an !reate !%roni! $ron!%itis.

*mp%sema is anot%er tpe of '-6D.

◦ oss of elasti! material aro#nd air spa!es

◦ 'a#ses in!l#de inflamed airwas, smoking.

Most patients wit% '-6D %ave elements of $ot%!%roni! $ron!%itis and emp%sema.



Asthma3 4ay 5ever3 andAsthma3 4ay 5ever3 andAnaphyla6isAnaphyla6is

"es#lt of allergi! rea!tion to in%aled, ingested, or in2e!teds#$stan!e

◦ 1n some !ases, allergen !annot $e identified.

Ast%ma is a!#te spasm of smaller air passages($ron!%ioles)

◦ *!essive m#!#s prod#!tion

◦ Swelling of m#!o#s lining of respirator passages.

4a fever !a#ses !old=like smptoms.

◦ Allergens in!l#de pollen, d#st mites, pet dander.

Anap%la!ti! rea!tion !an prod#!e severe airwa swelling.

◦ Total o$str#!tion is possi$le.

◦ "ea!tion o!!#rs wit%in + min#tes of epos#re



4yperventilation4yperventilation

"apid, deep $reat%ing to t%e point t%at arterial !ar$ondioide falls $elow normal

Ma $e indi!ator of ma2or illness

◦ 4ig% $lood s#gar, overdose of aspirin, respiratorinfe!tion, et!

A!idosis: $#ild#p of e!ess a!id in $lood or $odtiss#es

Alkalosis: $#ild#p of e!ess $ase in $od fl#ids

Alkalosis !an !a#se smptoms of pani! atta!k,in!l#ding:

◦ Aniet

◦ Dizziness

◦ B#m$ness



Cystic 5i*rosisCystic 5i*rosis

◦Eeneti! disorder t%at affe!ts l#ngsand digestive sstem

◦Disr#pts $alan!e of salt and waterres#lting in ver t%i!k m#!#s

◦Disposed to repeated l#nginfe!tions and mala$sorption ofn#trients in intestines



'ardia! pro$lem t%at !a#ses fl#id to $a!k#p in t%e l#ngs

◦ "isk fa!tors in!l#de %pertension and a %istorof !oronar arter disease andCor atrialfi$rillation.

◦ 1n most !ases, patients %ave a %istor of!ongestive %eart fail#re.



TreatmentTreatment

4ave patient ass#me a !omforta$leposition, #s#all sitting #p and leaning

forward.oosen an tig%t !lot%ing.7ollow t%eir do!tors orders for an

medi!ation administration.1f t%ere is ogen on s!ene, it is %elpf#l in

!ases of D1&.



T*"1MA KAS14

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Henti Nafas Pada Anak Dan Dewasa